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632.87
(8) (a) In this subsection:
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1. “Health care provider” has the meaning given in s. 146.81 (1) (a) to (hp).
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2. “Substance abuse counselor” means a substance abuse counselor certified
21under s. 440.88.
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(b) No policy, plan, or contract may exclude coverage for alcoholism or other
23drug abuse treatment or services provided by a substance abuse counselor within the
24scope of the substance abuse counselor's education and training if the policy, plan,
1or contract covers the alcoholism or other drug abuse treatment or services when
2provided by another health care provider.
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4632.871 Telehealth services. (1)
Definitions. In this section:
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(a) “Disability insurance policy” has the meaning given in s. 632.895 (1) (a).
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(b) “Self-insured health plan” means a self-insured health plan of the state or
7a county, city, village, town, or school district.
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(c) “Telehealth" means a practice of health care delivery, diagnosis,
9consultation, treatment, or transfer of medically relevant data by means of audio,
10video, or data communications that are used either during a patient visit or a
11consultation or are used to transfer medically relevant data about a patient.
12“Telehealth" does not include communications delivered solely by audio-only
13telephone, facsimile machine, or email unless specified otherwise by rule.
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14(2) Coverage denial prohibited. No disability insurance policy or self-insured
15health plan may deny coverage for a treatment or service provided through
16telehealth on the basis that the treatment or service is provided through telehealth
17if that treatment or service is covered by the disability insurance policy or
18self-insured health plan when provided in person. A disability insurance policy or
19self-insured health plan may limit coverage of treatments or services provided
20through telehealth to those treatments or services that are medically necessary.
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21(3) Certain limitations on telehealth prohibited. A disability insurance
22policy or self-insured health plan may not subject a treatment or service provided
23through telehealth for which coverage is required under sub. (2) to any of the
24following:
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1(a) Any greater deductible, copayment, or coinsurance amount than would be
2applicable if the treatment or service is provided in person.
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(b) Any policy or calendar year or lifetime benefit limit or other maximum
4limitation that is not imposed on other treatments or services covered by the
5disability insurance policy or self-insured health plan that are not provided through
6telehealth.
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(c) Prior authorization requirements that are not required for the same
8treatment or service when provided in person.
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(d) Unique location requirements.
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10(4) Disclosure of coverage of certain telehealth services. A disability
11insurance policy or self-insured health plan that covers a telehealth treatment or
12service that has no equivalent in-person treatment or service, such as remote patient
13monitoring, shall specify in policy or plan materials the coverage of that telehealth
14treatment or service.
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(1)
Prescription drug importation program. The commissioner of insurance
17shall submit the first report required under s. 601.575 (5) by the next January 1 or
18July 1, whichever is earliest, that is at least 180 days after the date the prescription
19drug importation program is fully operational under s. 601.575 (4). The
20commissioner of insurance shall include in the first 3 reports submitted under s.
21601.575 (5) information on the implementation of the audit functions under s.
22601.575 (1) (n).
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(2)
Public option health insurance plan. The office of the commissioner of
24insurance may expend from the appropriation under s. 20.145 (1) (a) in fiscal year
12023-24 not more than $1,000,000 for the development of a public option health
2insurance plan.
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(3)
Prescription drug purchasing entity. During the 2023-2025 fiscal
4biennium, the office of the commissioner of insurance shall conduct a study on the
5viability of creating or implementing a state prescription drug purchasing entity.
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(1)
Telehealth parity.
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(a) For policies and plans containing provisions inconsistent with the
9treatment of s. 632.871, the treatment of s. 632.871 first applies to policy or plan
10years beginning on January 1 of the year following the year in which this paragraph
11takes effect, except as provided in par. (b
).
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(b) For policies and plans that are affected by a collective bargaining agreement
13containing provisions inconsistent with the treatment of s. 632.871, the treatment
14of s. 632.871 first applies to policy or plan years beginning on the effective date of this
15paragraph or on the day on which the collective bargaining agreement is newly
16established, extended, modified, or renewed, whichever is later.
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(2)
Substance abuse counselor coverage.
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(a) For policies and plans containing provisions inconsistent with the
19treatment of s. 632.87 (8), the treatment of s. 632.87 (8) first applies to policy or plan
20years beginning on January 1 of the year following the year in which this paragraph
21takes effect, except as provided in par. (b
).
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(b) For policies and plans that are affected by a collective bargaining agreement
23containing provisions inconsistent with the treatment of s. 632.87 (8), the treatment
24of s. 632.87 (8) first applies to policy or plan years beginning on the effective date of
1this paragraph or on the day on which the collective bargaining agreement is newly
2established, extended, modified, or renewed, whichever is later.
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(3)
Application of manufacturer discounts.
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(a) For policies and plans containing provisions inconsistent with the
5treatment of s. 632.862, the treatment of s. 632.862 first applies to policy or plan
6years beginning on January 1 of the year following the year in which this paragraph
7takes effect, except as provided in par. (b
).
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(b) For policies or plans that are affected by a collective bargaining agreement
9containing provisions inconsistent with the treatment of s. 632.862, the treatment
10of s. 632.862 first applies to policy or plan years beginning on the effective date of this
11paragraph or on the day on which the collective bargaining agreement is newly
12established, extended, modified, or renewed, whichever is later.
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(1)
Substance abuse counselor coverage. The treatment of s. 632.87 (8) and
15Section 9323 (2
) of this act take effect on the first day of the 4th month beginning
16after publication.”.
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20.435
(1) (fL)
Nurse aide training and recruitment grants. The amounts in
3the schedule for grants to train and recruit individuals to work as nurse aides in
4nursing homes under s. 146.41.
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6146.41 Nurse aide training and recruitment grants. (1) In this section:
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(a) “Nurse aide” has the meaning given in s. 146.40 (1) (d).
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(b) “Nursing home" has the meaning given in s. 50.01 (3).
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9(2) Beginning in fiscal year 2024-25, the department shall award grants to
10train and recruit individuals to work as nurse aides in nursing homes. The grants
11awarded under this subsection shall include grants for all of the following:
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(a) The cost for an individual to complete an instructional program for nurse
13aides in a program approved under s. 146.40 (3) and (3g).
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(b) The cost for an individual to complete a competency evaluation for nurse
15aides in a program approved under s. 146.40 (3m).
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(c) A retention bonus for an individual who has worked for at least 6 months
17as a nurse aide in a nursing home.
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18(3) The department may partner with nonprofit organizations, private entities,
19the board on aging and long term care, and the technical college system board to
20award the grants under sub. (2) and recruit individuals to work as nurse aides in
21nursing homes.”.
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20.250
(2) (title)
Research and community support.
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20.250
(2) (a)
Violence prevention grants. Biennially, the amounts in the
5schedule to make violence prevention grants supporting local, evidence-informed
6activities that enhance the safety and well-being of children, youth, and families
7throughout this state.”.
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20.435
(1) (ew)
Congenital disorders; general purpose revenue. The amounts
13in the schedule to provide diagnostic services, special dietary treatment, and
14follow-up counseling for congenital disorders and periodic evaluation of infant
15screening programs as specified under s. 253.13, to provide referrals under s.
16253.115, to administer the programs under ss. 253.115 and 253.13, and for the costs
17of consulting with appropriate experts as specified in s. 253.13 (5).”.
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1“
Section 1. 252.12 (2) (a) 8. (intro.) of the statutes is amended to read:
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252.12
(2) (a) 8. `Mike Johnson life care and early intervention services grants.'
3(intro.) The department shall award not more than
$4,000,000 $5,000,000 in each
4fiscal year in grants to applying AIDS service organizations for the provision of needs
5assessments; assistance in procuring financial, medical, legal, social and pastoral
6services; counseling and therapy; homecare services and supplies; advocacy; and
7case management services. These services shall include early intervention services.
8The department shall also award not more than $74,000 in each year from the
9appropriation account under s. 20.435 (5) (md) for the services under this
10subdivision. The state share of payment for case management services that are
11provided under s. 49.45 (25) (be) to recipients of medical assistance shall be paid from
12the appropriation account under s. 20.435 (1) (am). All of the following apply to
13grants awarded under this subdivision:”.
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16(1) Office of Caregiver Quality position increase. The authorized FTE
17positions for the department of health services are increased by 2.8 FED positions,
18beginning in fiscal year 2023-24, to be funded from the appropriation under s. 20.435
19(6) (n) for the purpose of increasing staffing in the division of the department
20responsible for caregiver quality.”.
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20.435
(1) (bc)
Emergency medical services grants. As a continuing
3appropriation, the amounts in the schedule for grants to providers of emergency
4medical services under s. 256.42.
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6256.42 Emergency medical services grants. From the appropriation under
7s. 20.435 (1) (bc), the department may award grants to providers of emergency
8medical services for reasonable operating expenses related to emergency medical
9services, including expenses related to supplies, equipment, training, staffing, and
10vehicles.”.
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20.435
(4) (jw)
BadgerCare Plus and hospital assessment. All
moneys received
14from payment of enrollment fees under the program under s. 49.45 (23), all moneys
15transferred under s. 50.38 (9), all moneys transferred from the appropriation account
16under par. (jz), and 10 percent of all moneys received from penalty assessments
17under s. 49.471 (9) (c),
for administration of the program under s. 49.45 (23), to
18provide a portion of the state share of administrative costs for the BadgerCare Plus
1Medical Assistance program under s. 49.471
, and for administration of the hospital
2assessment under s. 50.38.
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49.471
(1) (cr) “Enhanced federal medical assistance percentage" means a
8federal medical assistance percentage described under
42 USC 1396d (y) or (z).
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9Section 309n. 49.471 (4) (a) 4. b. of the statutes is amended to read:
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49.471
(4) (a) 4. b. The individual's family income does not exceed
100 133 11percent of the poverty line
before application of the 5 percent income disregard under
1242 CFR 435.603 (d).
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49.471
(4) (a) 8. An individual who meets all of the following criteria:
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a. The individual is an adult under the age of 65.
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b. The adult has a family income that does not exceed 133 percent of the poverty
17line, except as provided in sub. (4g).
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c. The adult is not otherwise eligible for the Medical Assistance program under
19this subchapter or the Medicare program under
42 USC 1395 et seq.
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49.471
(4g) Medicaid expansion; federal medical assistance percentage. For
22services provided to individuals described under sub. (4) (a) 8., the department shall
23comply with all federal requirements to qualify for the highest available enhanced
24federal medical assistance percentage. The department shall submit any
25amendment to the state medical assistance plan, request for a waiver of federal
1Medicaid law, or other approval request required by the federal government to
2provide services to the individuals described under sub. (4) (a) 8. and qualify for the
3highest available enhanced federal medical assistance percentage.
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49.686
(3) (d) Has applied for coverage under and has been denied eligibility
6for medical assistance within 12 months prior to application for reimbursement
7under sub. (2). This paragraph does not apply to an individual
who is eligible for
8benefits under the demonstration project for childless adults under s. 49.45 (23) or
9to an individual who is eligible for benefits under BadgerCare Plus under s. 49.471
10(4) (a) 8. or (11).
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(2h)
Childless adults demonstration project. The department of health
14services shall submit any necessary request to the federal department of health and
15human services for a state plan amendment or waiver of federal Medicaid law or to
16modify or withdraw from any waiver of federal Medicaid law relating to the childless
17adults demonstration project under s. 49.45 (23), 2021 stats., to reflect the
18incorporation of recipients of Medical Assistance under the demonstration project
19into the BadgerCare Plus program under s. 49.471 and the termination of the
20demonstration project.
